Substance Use Disorder Testing

Paper Title

Name

Institution Name

Substance Use Disorder Testing

Efficient, reliable and systematized evaluations for drug uses disorder are very significant for medical investigation, treatment preparation and also for the approval to adjunctive facilities. The suitable method to evaluate a drug use disorder is based on the objective. While methods like unstructured medical interviews are effective for numerous purposes, but only planned interviews give enough information and also reliability. In case of planned instruments, a standardized comparison is made between patient’s certain characteristics with those patients who profited from the interference in clinical trials. Among many substance use disorder instruments, Addiction Severity Index (ASI) is used to screen for problems and other deficiencies that are commonly noticed in case of drug abuse and also dependence. It was first introduced in 1980 as a complete instrument to evaluate the deficiencies that commonly occurs in individuals who are addicted to drug or alcohol use. It was slightly modified in 1992 but the general purpose was the same as in 1980 ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"cAtfU2Yr","properties":{"formattedCitation":"(Denis, Cacciola, & Alterman, 2013)","plainCitation":"(Denis, Cacciola, & Alterman, 2013)","noteIndex":0},"citationItems":[{"id":526,"uris":["http://zotero.org/users/local/4C6u8dIT/items/KPD45DWA"],"uri":["http://zotero.org/users/local/4C6u8dIT/items/KPD45DWA"],"itemData":{"id":526,"type":"article-journal","title":"Addiction Severity Index (ASI) summary scores: comparison of the Recent Status Scores of the ASI-6 and the Composite Scores of the ASI-5","container-title":"Journal of substance abuse treatment","page":"444-450","volume":"45","issue":"5","source":"PubMed Central","abstract":"The characteristics and the validity of the Recent Status Scores (RSSs), the new summary scores generated by the 6th version of the Addiction Severity Index (ASI-6), are compared to the 5th version of the ASI summary scores, the Composite Scores (CSs). A sample of 82 randomly selected patients from substance abuse treatment programs were interviewed with the ASI-6, the ASI-5 and were administered a validity battery of self-questionnaires that included measures corresponding to each of the ASI domains. Each ASI-6 RSS was significantly correlated with its corresponding ASI-5 CS. The intercorrelations among the RSSs are low and none of these correlations was statistically different from the intercorrelations among CSs. In five of the seven areas, the ASI-6 RSSs were more highly correlated to the corresponding validity measures than were the ASI-5 CSs. The ASI-6 offers more comprehensive content in its scales than do those derived with earlier ASIs.","DOI":"10.1016/j.jsat.2013.06.003","ISSN":"0740-5472","note":"PMID: 23886822\nPMCID: PMC4049003","shortTitle":"Addiction Severity Index (ASI) summary scores","journalAbbreviation":"J Subst Abuse Treat","author":[{"family":"Denis","given":"Cécile M."},{"family":"Cacciola","given":"John S."},{"family":"Alterman","given":"Arthur I."}],"issued":{"date-parts":[["2013"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Denis, Cacciola, & Alterman, 2013). The problems that are faced by the drug users and assessed in this instrument are basically interpersonal difficulties with families, friends and employees, legal troubles along with other medical problems like Hepatitis B and C, HIV and other sexually transmitted diseases.

With the help of ASI enough information is collected that can further be used by the clinicians to address substance abuse with the best suitable interventions. In case of the ASI seven different domains are used and the patient's life is evaluated on the basis of those seven domains. These domains are medical conditions, employment/support, family support, family/social status, psychiatric disorders and other alcohol or drug use. In this case a trained administrator interviews the patient to evaluate his/her stress level in each domain starting from 0 to 4 and once the interview is done the clinician or administrator, based on the interview conducted by the administrator evaluates the patient's need for cure in each of the seven domains starting from 0-9. Here 0 shows minimum intervention while 9 shows extreme medical and psychological interventions. Altogether, the administrator in ASI takes 50-60 minutes to manage along with the 10-20 minutes’ post-interview scoring.

The psychometric properties of ASI have been studied comprehensively. Other studies conducted by the ASI have also shown better to outstanding dependability and validity for this particular treatment. It is not important that ASI is effective all the time, there are certain populations for which this method cannot be used because of its ineffectiveness, like the homeless and dually diagnosed patients. The success of ASI results depends greatly on the interviewer's training and skills which improves the rationality of the ASI results.

This method is basically used for alcohol users and within a duration of an hour all the information is collected which are further used to treat the drug or alcohol users. The study has been used in a number of studies including patients who were cocaine-dependent and pathological gamblers. In this particular case ASI was used to determine the socio-economic characteristics of the subjects. Later on clinicians and researchers increased the usefulness of this instrument by adding questions related to free time activities, childhood religion, childhood illness, sexual orientation, age of first alcohol or drug use and any military services of the patients. These questions further help to screen the patients and add more information in the already compiled and brief information ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"5FfOfik6","properties":{"formattedCitation":"(Samet, Waxman, Hatzenbuehler, & Hasin, 2007)","plainCitation":"(Samet, Waxman, Hatzenbuehler, & Hasin, 2007)","noteIndex":0},"citationItems":[{"id":529,"uris":["http://zotero.org/users/local/4C6u8dIT/items/Y55WKAWZ"],"uri":["http://zotero.org/users/local/4C6u8dIT/items/Y55WKAWZ"],"itemData":{"id":529,"type":"article-journal","title":"Assessing Addiction: Concepts and Instruments","container-title":"Addiction Science & Clinical Practice","page":"19-31","volume":"4","issue":"1","source":"PubMed Central","abstract":"Efficient, organized assessment of substance use disorders is essential for clinical research, treatment planning, and referral to adjunctive services. In this article, we discuss the basic concepts of formalized assessment for substance abuse and addiction, as established by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, and describe six widely used structured assessment instruments. Our aim is to help researchers and clinical programs identify the instruments that best suit their particular situations and purposes.","ISSN":"1940-0632","note":"PMID: 18292706\nPMCID: PMC2797097","shortTitle":"Assessing Addiction","journalAbbreviation":"Addict Sci Clin Pract","author":[{"family":"Samet","given":"Sharon"},{"family":"Waxman","given":"Rachel"},{"family":"Hatzenbuehler","given":"Mark"},{"family":"Hasin","given":"Deborah S."}],"issued":{"date-parts":[["2007",12]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Samet, Waxman, Hatzenbuehler, & Hasin, 2007). Based on the information obtained, the patients are treated differently. The administrator will rate the patient from 0-9 and depending on the score, treatment for the patient will be determined. If the patient score is 1 then that patient will be given minor sessions like some motivations to give up the abuse and if the score is 8 or 9 then along with psychological treatment medical treatment will also be given to the patient. Psychological treatment includes individual treatment, support groups or some kind of social work that will improve the self-confidence of the patient and along with those treatments, medical treatment will also be administered like some antidepressants or sleep induce tablets.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Denis, C. M., Cacciola, J. S., & Alterman, A. I. (2013). Addiction Severity Index (ASI) summary scores: comparison of the Recent Status Scores of the ASI-6 and the Composite Scores of the ASI-5. Journal of Substance Abuse Treatment, 45(5), 444–450. https://doi.org/10.1016/j.jsat.2013.06.003

Samet, S., Waxman, R., Hatzenbuehler, M., & Hasin, D. S. (2007). Assessing Addiction: Concepts and Instruments. Addiction Science & Clinical Practice, 4(1), 19–31.